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Kelly Cheever, Jeffrey T. Howard and Keisuke Kawata

impacts has been shown to vary dramatically. 15 – 17 , 26 In order to increase the sensitivity of clinical measures of neuromuscular control, researchers have demonstrated the utility of coupling a motor task with a cognitive task. 27 – 30 Multimodal or dual-task (ie, cognitive task + a motor task

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Gabriela Souza de Vasconcelos, Anelize Cini and Cláudia Silveira Lima

Fencing is a sport of agility, characterized by, among others things, changes of direction and movements in acceleration and braking. 1 Its practice requires dynamic neuromuscular control, which is the athlete’s ability to maintain stability while moving quickly and reacting to changes in

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Nickolai Martonick, Kimber Kober, Abigail Watkins, Amanda DiEnno, Carmen Perez, Ashlie Renfro, Songah Chae and Russell Baker

During movement, dynamic joint stability is achieved through both passive ligament restraints and muscle forces acting on the joint. 1 Therefore, factors of neuromuscular control, such as muscle activation and strength, as well as the resulting kinetic and kinematic measures, should be considered when

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Kimmery Migel and Erik Wikstrom

gait in those with CAI. 6 These maladaptive gait biomechanics are thought to increase the risk of subsequent ankle sprains 8 and alter talar cartilage loading patterns leading to the development of posttraumatic osteoarthritis. 3 Neuromuscular control and balance training are frequently incorporated

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Hooman Minoonejad, Mohammad Karimizadeh Ardakani, Reza Rajabi, Erik A. Wikstrom and Ali Sharifnezhad

variety of sources, integrate and interpret that data, and select appropriate motor commands to achieve a movement goal. 5 Unfortunately, lateral ankle sprains and CAI result in feedback and feedforward neuromuscular control alterations. 6 Of particular interest are the altered muscle activity levels

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Brent I. Smith, Denice Curtis and Carrie L. Docherty

This response can be attributed to the disordered function of proprioceptive and neuromuscular control components associated with the initial injury. 19 As a result, there is a greater dependence on proximal corrections and a subsequent reliance on a hip strategy to maintain balance. 18 , 20 This

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C. Buz Swanik, Scott M. Lephart, Frank P. Giannantonio and Freddie H. Fu

Anterior cruciate ligament (ACL) injury disrupts static and dynamic knee restraints, compromising functional stability. Deafferentation of ACL mechan-oreceptors alters the spinal reflex pathways to motor nerves and muscle spindles in addition to the cortical pathways for conscious and unconscious appreciation of proprioception and kinesthesia. These pathways are required by the feed-forward and feedback neuromuscular control systems to dynamically stabilize joints. Feed-forward motor control is responsible for preparatory muscle activity, while feedback motor control regulates reactive muscle activity. The level of muscle activation, preparatory or reactive, influences muscular stiffness, thereby providing dynamic restraint for the ACL-deficient athlete. Rehabilitation protocols should incorporate activities that enhance muscle stiffness while encouraging adaptations to peripheral afferents, spinal reflexes, and cortical motor patterns. Four elements crucial for reestablishing neuromuscular control and functional stability are proprioceptive and kinesthetic awareness, dynamic stability, preparatory and reactive muscle characteristics, and conscious and unconscious functional motor patterns.

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Sangeetha Madhavan, Sarah Burkart, Gail Baggett, Katie Nelson, Trina Teckenburg, Mike Zwanziger and Richard K. Shields

Neuromuscular control strategies might change with age and predispose the elderly to knee-joint injury. The purposes of this study were to determine whether long latency responses (LLRs), muscle-activation patterns, and movement accuracy differ between the young and elderly during a novel single-limb-squat (SLS) task. Ten young and 10 elderly participants performed a series of resistive SLSs (~0–30°) while matching a computer-generated sinusoidal target. The SLS device provided a 16% body-weight resistance to knee movement. Both young and elderly showed significant overshoot error when the knee was perturbed (p < .05). Accuracy of the tracking task was similar between the young and elderly (p = .34), but the elderly required more muscle activity than the younger participants (p < .05). The elderly group had larger LLRs than the younger group (p < .05). These results support the hypothesis that neuromuscular control of the knee changes with age and might contribute to injury.

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Katrine Moreale, Jay Smith, David A. Krause and Diane L. Dahm

Objective:

To examine the accuracy and reliability of upper limb target pointing among normal subjects.

Design:

Prospective observational.

Setting:

Community sports-medicine practice.

Participants:

28 male and female normal right-handed volunteers age 22–35 years.

Intervention:

8-point target-pointing task completed with both upper limbs.

Main Outcome Measures:

Accuracy of point reproduction (cm error) and reliability over time (ICC2,1).

Results:

Target-pointing errors were 4.8–9.9 cm. Subject error and reach height explained 88% of performance variability. Error was greater when pointing to the lower half of the target (P < .05) and to ipsilateral points (P < .05). Gender, test day, reach length, and arm dominance did not affect accuracy. Test–retest reliability ranged from .30 to .71.

Conclusion:

Target-pointing tasks might be useful to assess upper limb neuromuscular control. Points with lower errors and greater reliabilities might be useful to differentiate normal vs abnormal performances, whereas a battery of reliable points over a spectrum of errors might be useful to document changes over time.

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Mary E. Ubinger, William E. Prentice and Kevin M. Guskiewicz

When the upper extremity is injured, open kinetic chain (OKC) exercises are primarily used to increase strength and restore functional ability—the goals of rehabilitation. It is also imperative, however, that the receptors responsible for static and dynamic stabilization of the joint be trained. This can be done with closed kinetic chain (CKC) exercises. The purposes of this study were to investigate the effect of a 4-week CKC training program on the neuromuscular control of the upper extremity and to determine whether there was a significant difference between skill-dominant limb and nondominant limb stability indices. Thirty-two physically active participants (14 men, 18 women) were tested on the FASTEX 4 weeks apart. The training group's scores significantly improved, whereas the control group's scores remained the same. It was concluded that the CKC training significantly improved the training group's ability to remain stable. The results suggest that CKC training can increase the accuracy of joint position sense because of increased stimulation of the mechanoreceptors.